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Am J Perinatol 2017; 34(01): 74-79
DOI: 10.1055/s-0036-1584274
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Preventing Maternal Morbidity from Obstetric Hemorrhage: Implications of a Provider Training Initiative

Michelle A. Kominiarek
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
,
Shirley Scott
2   Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
,
Abigail R. Koch
3   Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, Illinois
,
Maripat Zeschke
2   Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
,
Yvette Cordova
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
,
Samadh F. Ravangard
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
,
Deborah Schy
4   Advocate Lutheran General Hospital, Park Ridge, Illinois
,
Stacie E. Geller
2   Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois
3   Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, Illinois
› Author Affiliations
Further Information

Publication History

15 December 2015

16 April 2016

Publication Date:
30 May 2016 (online)

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Preventing Maternal Morbidity from Obstetric Hemorrhage: Implications of a Provider Training Initiative (Podcast)Am J Perinatol 2017; 34(01): e1-e1
DOI: 10.1055/s-0036-1593503

Abstract

Objective The objective of this study was to compare severe morbidity due to obstetrical hemorrhage and its potential preventability before and after a mandated provider training initiative on obstetric hemorrhage.

Study Design Cases of severe morbidity due to obstetric hemorrhage during 2006 (n = 64 before training initiative) and 2010 (n = 71 after training initiative) were identified by a two-factor scoring system of intensive care unit admission and/or transfusion of ≥ 3 units of blood products and reviewed by an expert panel. Preventable factors were categorized as provider, system, and/or patient related.

Results Potential preventability did not differ between 2006 and 2010, p = 0.19. Provider factors remained the most common preventable factor (88.2% in 2006 vs. 97.4% in 2010, p = 0.18), but the distribution in types of preventable factors improved over time for delay or failure in assessment (20.6 vs. 0%, p < 0.01) and delay or inappropriate treatment (76.5 vs. 39.5%, p < 0.01). System factors also differed (32.4 vs. 7.9%, p = 0.015) with a notable decline in factors related to policies and procedures (26.5 vs. 2.6%, p < 0.01) between 2006 and 2010.

Conclusion We found significant improvement in provider assessment and treatment of obstetric hemorrhage and a significant reduction in preventable factors related to policies and procedures after the training initiative.

Keywords

hemorrhage - maternal morbidity - provider training - provider education

Note

An abstract from this study was presented in poster format at the Central Association for Obstetricians and Gynecologists in Charleston, South Carolina, October 21–24, 2015.


Supplementary Material

 

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